表麻下行斜视矫正术的临床观察

目的观察盐酸奥布卡因滴眼液联合2%利多卡因表面麻醉下行斜视矫正术的临床麻醉效果。方法对90例（175眼）斜视术前滴盐酸奥布卡因滴眼液6次,常规行斜视矫正术且术中滴2%利多卡因3次。结果麻醉效果良好,术中剪切分离时无疼痛感,仅在牵位肌肉时有酸胀不适,经解释后手术配合良好。结论斜视矫正术用盐酸奥布卡因联合2%利多卡因表面麻醉有效、并发症少。     

利多卡因和爱尔卡因在小切口非乳化白内障摘出术中的麻醉效果

目的 比较利多卡因注射液和爱尔卡因滴眼液在小切口非乳化白内障摘出术中麻醉效果的观察.方法 选择112例(125眼)白内障随机分成两组:利多卡因组和爱尔卡因组.分别在两种药物的表面麻醉下进行小切口白内障非乳化摘出联合人工晶状体植入术.根据术中患者对疼痛和触觉的感受评价麻醉效果.结果 利多卡因组中有60眼能顺利完成手术,有2眼疼痛明显,加用其它麻醉方法完成手术.爱尔卡因组中有62眼能顺利完成手术,有1眼疼痛明显,加用其它麻醉方法勉强完成手术(P>0.75).结论 利多卡因注射液具有较好的麻醉效果,并且药液新鲜、价廉易得,在小切口白内障非乳化摘出术中可作为首选的表面麻醉剂.     

表面麻醉下小切口白内障囊外摘除人工晶体植入临床观察

目的 评价及观察倍诺喜（盐酸奥布卡因）滴眼液在白内障摘除＋人工晶体植入术中的麻醉效果。方法 采用0．4％倍诺喜滴眼5rain1次，共滴3次顺利完成451例（472眼）白内障囊外摘除＋人工晶体植入术。结果 无任何痛苦与不适448眼，占95％，其中仅24眼出现轻度疼痛，加滴1次倍诺喜则症状消失。结论 表面麻醉效果明显，且具有无明显的毒副作用及并发症等诸多优点，因此，我们认为表面麻醉下的白内障囊外摘除手术是安全有效的手术方法。     

利多卡因联合布比卡因表面麻醉进行晶状体超声乳化术的观察

目的观察利多卡因联合布比卡因表面麻醉进行晶状体超声乳化人工晶状体植入术的情况，同时与奥布卡因表面麻醉剂比较，分析他们的相似性。方法我们分别运用利多卡因联合布比卡因麻醉剂，以及奥布卡因麻醉剂在表面麻醉下进行晶状体超声乳化术各100眼，比较二者的安全性、有效性。并观察两组患者术中情绪、眼位固定情况、眼球不自主运动、痛觉、以及麻醉持续时间。结果利多卡因联合布比卡因麻醉剂表面麻醉进行晶状体超声乳化术具有良好的麻醉作用。结论在进行晶状体超声乳化术中，应用利多卡因联合布比卡因麻醉剂作表面麻醉剂，具有良好的麻醉作用和安全性，与奥布卡因麻醉剂作用相似，而且经济。     

表面麻醉下超声乳化白内障摘除及人工晶体植入术的临床观察

目的 察应用利多卡因行表面麻醉在超声乳化白内障摘除及人工晶体植入术中的临床效果。方法 应用利多卡因作单纯角结膜表面麻醉，实施白内障超声乳化及人工晶体植入术456例（495眼），并观察其麻醉效果。结果 456眼（92．12％）术中完全不感疼痛或偶感轻微疼痛，手术配合良好。34眼（6．87％）术中疼痛，需加点利多卡因1～2次后才顺利完成手术；5眼（1．01％）术中疼痛，需加用球后或球周麻醉方可完成手术。结论 利多卡因表面麻醉是实施超声乳化白内障摘除及人工晶体植入术的有效麻醉方法。     

表面麻醉在基层医院防盲白内障手术中应用

目的分析在大规模防盲白内障手术中使用表面麻醉的效果。方法113眼在爱尔卡因表面麻醉后进行小切口白内障摘除联合人工晶体植入术。结果98眼（86．72％）于单纯表面麻醉下完成手术,15眼（13．28％）加用2％利多卡因滴眼后完成手术。手术时间平均14．12min。术后视力恢复较好,并发症少。结论表面麻醉下小切口白内障摘除联合人工晶体植入术适于在基层医院防盲白内障手术中推广应用。     

表面麻醉下小梁切除术的临床观察

目的 探讨用2％利多卡因表面麻醉行小梁切除术的临床效果。方法 30例青光眼患者术前术眼滴0．5％地卡因1滴，术中用2％利多卡因相片置于手术野球结膜表面1分钟，常规小梁切除术。结果 麻醉效果满意27例；麻醉欠满意3例；无1例麻醉不满意。结论 2％利多卡因表面麻醉下行小梁切除术。麻醉方法简单、易行。并发症少。手术时间短。是值得推广的麻醉方法。     

表麻加结膜下浸润麻醉在抗青光眼手术中的临床应用

目的 探讨表麻加结膜下浸润麻醉进行青光眼手术的可行性，分析其安全性。方法 对49例63眼青光眼手术用倍诺喜(0．4％盐酸奥布卡因)眼液表面麻醉和2％利多卡因结膜下浸润麻醉。结果 用于青光眼手术，均顺利完成手术。不但镇痛效果好，节约手术时间，避免球后麻醉的并发症，缩短手术时间，而且减少对晚期青光眼手术的风险。结论 表麻加结膜下浸润麻醉对青光眼手术是一种安全、有效及简便易行的麻醉选择，尤其是对于晚期青光眼值得推广使用。     

眼前节麻醉下白内障手术

目的阐述眼前节麻醉的方法和评估眼前节麻醉下行白内障手术的可靠性、有效性和安全性。方法眼前节麻醉的方法为0．4％盐酸奥布卡因表面麻醉联合近角膜缘球结膜下2％利多卡因0．4ml注射。对552眼白内障患者经眼前节麻醉进行白内障手术，随机抽取同期552眼采用球后麻醉行白内障手术的患者作为对照组，比较两组患者麻醉镇痛效果和麻醉存在的并发症。结果球后麻醉组2眼术中黑朦，5眼球后出血，1眼中枢抑制，12眼后囊膜破裂，9眼术中有疼痛感；眼前节麻醉有5眼后囊破裂，41眼术中有可忍受的酸痛。2组患者均能较好地进行手术，眼前节麻醉中所有患者均能较好地配合手术，术中眼位可以很好地随医生的要求改变。结论眼前节麻醉是一种白内障可靠、安全且并发症较少麻醉方法。     

表面麻醉小切口非超声乳化白内障手术的临床效果分析

目的观察表面麻醉小切口非超声乳化白内障手术的临床效果。方法行小切口非超声乳化白内障人工晶体手术治疗白内障的患者98例（109眼），随机分为表面麻醉组49例（54眼）和球后麻醉组49例（55眼）。球后麻醉组给予2％利多卡因球后阻滞麻醉。表面麻醉组给予倍诺喜（盐酸奥布卡因0．4％）表面麻醉。结果采用表面麻醉和球后麻醉的麻醉效果比较差异无统计学意义（P〉0．05），同时手术后1个月视力以及散光度情况比较差异无统计学意义（P〉0．05）。但是表面麻醉组的手术时间要显著短于球后麻醉组，表面麻醉组并发症的发生率显著低于球后麻醉组（P〈0．05）。结论表面麻醉下行小切口非超声乳化白内障摘除联合人工晶体植入术麻醉效果良好，能最大限度减少麻醉所带来的并发症，大大减少了病人的痛苦。     

Efficacy of 2% Lidocaine Injection as a Topical Agent in Cataract Surgery

Purpose: To determine whether 2％ Lidocaine injection is an effective topical anesthetic agent for non-phaco small incision cataract surgery.Setting: Charity eye clinic supported by Hellen Keller International.Methods: One hundred and twenty-five consecutive cataract surgery patients received topical anesthesia with 2％ Lidoeaine injection solution just 1 and 0.5 minutes prior to non-phaeo small incision cataract extraction and intraocular lens implantation. Each patient was asked about pain or pressure sensation during the operation.Results: The surgeon felt ease in the operations. Many patients (93/125) were comfort during the whole surgery. Only 9 patients'score was above level 3, mostly complained during the nucleus extraction; Among those whose score was level 1～2, 82.6％(19/23) claimed discomfort at middle of the operation (nucleus extraction) or the beginning (creating the conjunctival flap).Conclusion: Lidocaine injection solution(2％) was an effective topical anesthesia agent in cataract surge     

小切口非乳化白内障手术不同麻醉方法的效果

目的比较小切口非超声乳化白内障摘出术中表面麻醉与球后麻醉的麻醉效果。方法 95例（95眼）白内障随机分为A、B两组,A组48例使用0.5%爱尔凯因表面麻醉;B组47例使用传统的球后麻醉。两组均行小切口非超声乳化白内障摘出及人工晶状体植入术,对麻醉效果和并发症进行分析。结果两组麻醉效果均满意,麻醉并发症的发生率A组低于B组（χ^2=4.18,P〈0.05）。结论表面麻醉下小切口非超声乳化白内障摘出术安全有效,并发症少。     

Topical versus sub-Tenon's anesthesia without sedation in cataract surgery.

PURPOSE: To compare pain control using topical anesthesia with that using sub-Tenon's anesthesia for clear corneal phacoemulsification cataract surgery and foldable intraocular lens (IOL) implantation. SETTING: Departments of Ophthalmology, General Hospital Asklepeion Voulas and General Hospital of Athens, University of Athens, Athens, Greece. METHODS: One hundred consecutive patients scheduled for bilateral cataract surgery 1 to 2 months apart were prospectively randomized to receive topical anesthesia (100 eyes) or sub-Tenon's anesthesia (100 eyes). The randomization was stratified so that one half of first-eye surgeries and one half of second-eye surgeries were assigned to each anesthesia group, with each patient receiving each type of anesthesia once. All patients had clear corneal phacoemulsification with foldable IOL implantation. Patients were asked to rate their pain level on a 10-point scale for 4 periods: during the administration of the anesthetic agent, during surgery, immediately after surgery, and 24 hours postoperatively. The surgeon recorded his subjective assessment of ease of surgery and surgical complications using a standardized template. RESULTS: Eighty-one percent of patients who received topical anesthesia and 8% of patients who received sub-Tenon's anesthesia reported no pain during delivery of the anesthetic agent. The mean pain score was 0.19 +/- 0.39 (SD) in the topical group and 1.35 +/- 0.63 in the sub-Tenon's group. The difference between groups was statistically significant (P <.001). Seventy-two percent of patients in the topical anesthesia group and 86% in the sub-Tenon's anesthesia group reported no pain or slight discomfort during surgery (mean score 1.13 +/- 1.57 and 0.57 +/- 1.28, respectively) (P <.001). Ninety percent of topical anesthesia patients and 100% of sub-Tenon's anesthesia patients reported no pain or slight discomfort 30 minutes postoperatively (mean score 0.80 +/- 0.93 and 0.12 +/- 036, respectively) (P <.001). All patients in the topical anesthesia group and 77% in the sub-Tenon's group reported no pain 24 hours postoperatively (mean pain 0.00 +/- 0.00 and 0.23 +/- 0.40, respectively) (P <.001). Complications including prolonged akinesia of the globe, chemosis, and conjunctival hemorrhage occurred significantly more frequently in the sub-Tenon's than in the topical group (P <.001). CONCLUSIONS: Patients having cataract surgery under topical anesthesia had more intraoperative and postoperative discomfort than patients receiving sub-Tenon's anesthesia. However, patients having topical anesthesia reported less pain during its administration and had fewer complications. Both anesthesia methods provided high levels of pain control without additional sedation.     

超声乳化术中表面麻醉剂的止痛效果

目的：本文报告1200例超声乳化白内障手术中表面麻醉的止痛效果。方法：术中采用0．4％Oxybuprocaine和0.4%Alcaine表面麻醉,经巩膜隧道切口完成常规超声乳化手术,植入单片式PMMA硬质人工晶体和三片式折叠式人工晶体。结果：80％手术病人术中没有任何疼痛感,20％病人（365眼次）在手术不同步骤时有疼痛感,其中有49眼（3．9％）,追加球后麻醉。     

Topical plus intracameral lidocaine versus retrobulbar anesthesia in phacotrabeculectomy: prospective randomized study

PURPOSE: To compare the efficacy and safety of topical and retrobulbar anesthesia for phacotrabeculectomy. SETTING: Hospital Ramón y Cajal, Madrid, Spain. METHODS: This prospective study comprised 60 patients (60 eyes) having phacotrabeculectomy surgery. Patients were randomly assigned to 1 of 2 groups receiving topical anesthesia plus intracameral lidocaine 1% or retrobulbar anesthesia. Patients were asked to document the discomfort they experienced during the administration of the anesthetic agent, during surgery, and postoperatively using a numeric pain scale. Complications and surgical conditions were also evaluated. RESULTS: The retrobulbar group reported significantly more discomfort during administration of the anesthetic agent than the topical group (P < .001). The topical group reported significantly more discomfort intraoperatively (P < .01). Eyelid squeezing and eyeball movement were more common in the topical group; however, neither was a problem to the surgeon. There was no difference in surgical conditions (P = .38) or the postoperative pain scores between the 2 groups (P = .06). One patient receiving topical anesthesia developed a suprachoroidal hemorrhage intraoperatively. CONCLUSIONS: Topical anesthesia supplemented with intracameral lidocaine was an effective alternative to retrobulbar anesthesia for phacotrabeculectomy. Although the degree of patient discomfort was significantly higher during surgery under topical anesthesia, the method avoids the pain and complications associated with a retrobulbar injection.     

Posterior vitrectomy under topical anesthesia

BACKGROUND: To determine the safety and efficacy of topical anesthesia in posterior vitrectomy. METHODS: A total of 93 patients (93 eyes) with various vitreoretinal diseases not needing scleral buckling and with short predicted duration of surgery underwent posterior vitrectomy under topical (49 eyes) or retrobulbar (44 eyes) anesthesia. Patients in the topical group were sedated with neuroleptic anesthesia. Postoperatively, patients were shown a visual analogue pain scale (VAPS) from 0 (no pain) to 10 (unbearable pain) to rate the levels of pain. The main outcome measures were overall and worst intraoperative pain scores, duration of surgery, and pain score during the administration of the retrobulbar anesthetic agent. RESULTS: Mean surgical time was 57.9 minutes in the topical group and 56.6 minutes in the retrobulbar group (p > 0.05). The pain scores were not significantly different. Mean overall pain scores were 1.71 (SD 1.04, range 0-5) in the topical group and 1.38 (SD 1.04, range 0-3) in the retrobulbar group (p > 0.05). Mean worst pain scores were 3.20 (SD 1.30, range 1-7) and 2.95 (SD 0.73, range 1-4), respectively (p > 0.05). There was no significant correlation between duration of surgery and overall pain score in either group (r = 0.146, p = 0.356, and r = 0.174, p = 0.385, respectively). No patient required additional injection anesthesia in the topical group. INTERPRETATION: Topical anesthesia combined with systemic sedation and analgesia in posterior vitrectomy procedures provided sufficient analgesic effects in selected patients needing no scleral buckling and with short predicted surgery time.     

Provision of anesthesia with single application of lidocaine 2% gel.

PURPOSE: To compare the efficacy of a single application of lidocaine 2% gel with tetracaine 0.5% drops for topical anesthesia in clear corneal cataract surgery. SETTING: The Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. METHODS: A preliminary toxicity study applied lidocaine 2% gel in the conjunctival fornices of rabbit eyes (n = 9). Biomicroscopic examination was performed and then enucleation at sequential intervals after the application. Intentional intracameral injection of lidocaine gel was performed (n = 3), followed by enucleation. Histopathological analysis was performed on all eyes. A randomized clinical trial comparing topical anesthesia in clear corneal cataract surgery was performed in 25 eyes of 25 patients (12 eyes randomly assigned to lidocaine gel, 13 eyes to tetracaine drops). Corneal sensation was measured with the Cochet-Bonnet aesthesiometer before application of the topical anesthesia, 5 minutes after application, and at the conclusion of surgery. Additional intraoperative local anesthesia and systemic sedation were recorded. Patients' subjective level of comfort was reported 20 minutes after surgery, and the surgeon's perception of patients' comfort was also noted. RESULTS: In rabbits, lidocaine gel did not cause clinical or histopathological alteration of the ocular tissues. In the clinical study, median corneal sensitivity before application, after 5 minutes, and postoperatively was 6, 0, 0 (maximum sensitivity = 6), respectively, in the lidocaine gel group and 5, 0, 0, respectively, in the tetracaine drops group. Additional local anesthesia was administered in 17% and 31% of patients, respectively. Satisfactory comfort was reported by 58% in the lidocaine gel group and 62% in the tetracaine drops group. CONCLUSIONS: A single application of lidocaine 2% gel was a safe and effective alternative to multiple topical anesthetic drops for clear corneal cataract surgery. Lidocaine 2% gel was similar to tetracaine drops in provision of corneal anesthesia and patient comfort, while causing no significant toxicity to the ocular surface.     

筋膜下麻醉小梁切除术

目的:探讨筋膜下麻醉行小梁切除术的有效性及安全性。方法:在连续58例(60眼)青光眼小梁切除术中分别应用表面麻醉、球后麻醉、筋膜下麻醉各20眼,观察麻醉效果、并发症情况。结果:表面麻醉组患者术中在上直肌牵引缝线、巩膜电凝、周边虹膜切除、结膜缝合时有不同程度痛感,筋膜下麻醉、球后麻醉组患者术中无明显痛感,筋膜下麻醉组1眼、球后麻醉组2眼术中出现一过性黑矇,球后麻醉组术中出现球后出血1眼,术后短暂性上睑下垂2眼。结论:小梁切除术采用筋膜下麻醉具有麻醉效果好、并发症少的优点,是理想麻醉方法。     

盐酸奥布卡因表面麻醉剂在斜视矫正术中的应用

目的:探讨盐酸奥布卡因滴眼液表面麻醉下行斜视矫正术的临床麻醉效果。方法:对118例斜视患者术前滴盐酸奥布卡因滴眼液5次,常规行斜视矫正术。结果:Ⅰ级麻醉效果83例(70.3%),Ⅱ级麻醉效果34例(28.8%),因眼胃反射终止手术1例。结论:盐酸奥布卡因表面麻醉下行斜视矫正术安全、有效、并发症少,简单易行。